scholarly journals FEATURES OF HEMOSTASIS IN DIFFERENT TYPES OF 24 HOURS DAY'S PROFILE OF BLOOD PRESSURE IN HYPERTENSIVE PATIENTS OF DIFFERENT AGE GROUPS

2021 ◽  
Vol 2 (16) ◽  
pp. 57-62
Author(s):  
V.S. Pasko
Keyword(s):  
Blood Pressure ◽  
Elderly Patients ◽  
Age Groups ◽  
Control Group ◽  
Middle Aged ◽  
Platelet Activity ◽  
Aged Patients ◽  
Hypertensive Patients ◽  
Group I ◽  
Induced Aggregation

In most patients of both groups revealed changes in hemostasis in the direction of increasing the aggregation properties of platelets. However, more pronounced trends in such changes were found in patients with insufficient blood pressure at night. Given the fact that not only in the absence of control over hypertension and failure to achieve target blood pressure levels, but also with different daily blood pressure profiles, there is a high probability of thrombotic complications. That is why it was important for us to find out the peculiarities of the state of platelet aggregation indicators depending on 24 hours day’s profile of blood pressure. To date there are only isolated reports of hemostasis in this category of individuals. We conducted such studies in middle-aged and elderly patients. The aim of the study was to identify the baseline levels of hemostasis indices depending on 24 hours day’s profile of blood pressure in middle-aged and elderly hypertensive patients. Material and methods. We performed the comparative assessment of status of hemostasis in 30 middle-aged (group I) and 30 elderly patients (group II) respectively to clarify this issue in our work. Patients of the surveyed groups were comparable in age, sex and related pathology. Control group consisted of 15 patients for every of the surveyed groups (group III the middle-aged and group IV the elderly respectively) matched with basic by age and gender. Conclusions. Thus, in hypertensive patients there is an increase in platelet activity with age which is more pronounced when stimulating ADP in non-dipper group compared to dipper. In addition in older patients the most significant changes are determined in spontaneous and adrenaline-induced aggregation compared with middle-aged patients.

scholarly journals STATE OF THE PLATELET HEMOSTASIS IN THE MIDDLE-AGED AND THE ELDERLY HYPERTENSIVE PATIENTS

2020 ◽  
Vol 2 (12) ◽  
pp. 120-125
Author(s):  
V. S. Pasko
Keyword(s):  
Essential Hypertension ◽  
Elderly Patients ◽  
The Elderly ◽  
Control Group ◽  
Middle Aged ◽  
Hypertensive Patients ◽  
Group I ◽  
Elderly Hypertensive ◽  
Elderly Hypertensive Patients ◽  
Induced Aggregation

It has long been known that complications of essential hypertension are associated mostly with disorders of blood coagulation system and degree of absolute risk of cardiovascular events is growing with increasing of age. That is why much attention is paid to more detailed study of mechanisms of thrombosis as the component of complications of essential hypertension through lens of hemostatic changes at present. Therefore, regulatory mechanisms of initiation of thrombus formation and participation of platelet hemostasis are studied in hypertensive patients insufficiently today. The aim of the study was to identify the baseline levels of the platelet hemostasis indices in the middle-aged and the elderly hypertensive patients. Material and methods. We performed the comparative assessment of status of the platelet hemostasis in 63 middle-aged (group I) and 53 elderly patients (group II) respectively to clarify this issue in our work. Patients of the surveyed groups were comparable in age, sex and related pathology. The control group consisted of 15 patients for every of the surveyed groups (group III the middle-aged and group IV the elderly respectively) matched with basic by age and gender. Conclusions. Therefore, there is the increase in platelet activity depending on age in the middle-aged and the elderly hypertensive patients that is manifested by adrenaline stimulation most clearly. In addition, the most significant changes are determined in the spontaneous and the adrenaline-induced aggregation namely in amplitude and slope of aggregation in the spontaneous and time of maximal aggregation in the adrenaline-induced aggregation in the patients of older age group compared with the middle-aged patients. The substantial deceleration of time of maximal aggregation during the adrenaline stimulated aggregation in 1,6 times (p<0,001) in the elderly patients confirms the expressed thrombogenicity and sensitiveness to neurohumoral influences too. Thus, the blood plasma thrombogenicity revealed in the study of the platelet hemostasis in the elderly indicates a high probability of thrombotic complications developing in this category of the patients and this is consistent with literature.

Age-associated features of the development of fibrosis and inflamaging in patients with arterial hypertension and ischemic stroke

2022 ◽  
pp. 879-884
Author(s):  
О.А. Осипова ◽  
Е.В. Гостева ◽  
О.Н. Белоусова ◽  
Н.И. Жернакова ◽  
Н.И. Клюшников ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Elderly Patients ◽  
Arterial Hypertension ◽  
Old Age ◽  
Control Group ◽  
Cerebral Stroke ◽  
Middle Aged ◽  
Aged Patients ◽  
Tnf Α ◽  
Immune Inflammation

В статье рассмотрены вопросы развития фиброза и иммунного воспаления у больных артериальной гипертензией (АГ) с острым ишемическим инсультом (ИИ) в пожилом возрасте. Цель исследования - изучение возраст-ассоциированных особенностей концентрации маркеров фиброза (металлопротеиназы-9, тканевого ингибитора матриксных металлопротеиназ-1, их соотношения ММП-9/ТИМП-1), иммунного воспаления (TNF-α, IL-1β, INF-γ) у больных АГ с ИИ. В исследование были включены 86 больных АГ II степени, из которых 42 человека - среднего возраста (53±5 лет) и 44 - пожилого (66±5 лет), контрольную группу составили 22 пациента пожилого возраста с АГ без ИИ в анамнезе. Критерии включения - пациенты с АГ, поступившие в стационар в остром периоде первого церебрального инсульта. Установлено, что у пожилых больных АГ с ИИ показатели инфламэйджинга и маркеры фиброза были достоверно выше, чем у лиц среднего возраста. Уровень IL-1β был выше на 31,7 % (р<0,01), TNF-α - на 55,7 % (р<0,001), INF-γ - на 36,6 % (р<0,01), уровень ММП-9 - на 46,4 % (р<0,01), ТИМП-1 - на 21,2 % (р<0,01), ММП-9/ТИМП-1 - на 19,6 % (р<0,01) в пожилом возрасте по сравнению с больными среднего возраста с АГ и острым ИИ. Таким образом, установлено, что больные АГ с ИИ имеют нарушения процессов инфламейджинга, синтеза и деградации внеклеточного матрикса, особенно выраженные в пожилом возрасте. The article deals with the development of fibrosis and immune inflammation in patients with arterial hypertension and acute ischemic stroke in old age. The aim of the study was to study age-associated features of the concentration of fibrosis markers (metalloproteinase-9, tissue inhibitor of matrix metalloproteinases-1, their ratio MMP-9/TIMP-1), immune inflammation (TNF-α, IL-1β, INF-γ) in patients with arterial hypertension and ischemic stroke (AI). The study included 86 patients with arterial hypertension (AH) of the 2nd degree, of which 42 were middle-aged (53±5 years) and 44 elderly (66±5 years). The control group consisted of 22 elderly patients with AH without a history of AI. The criteria for inclusion in the study are patients with hypertension who were admitted to the hospital in the acute period of the first cerebral stroke. It was found that in elderly patients with hypertension with AI, the indicators of inflamaging and fibrosis markers were significantly higher than in middle-aged people. The level of IL-1β was 31,7 % higher (p<0,01), TNF-α by 55,7 % (p<0,001), INF-γ by 36,6 % (p<0,01), the level of MMP-9 was 46,4 % higher (p<0,01), TIMP-1 by 21,2 % (p<0,01), MMP-9/TIMP-1 by 19,6 % (p<0,01) in the elderly compared to middle-aged patients with hypertension and acute AI. Thus, it was found that patients with arterial hypertension and ischemic stroke have violations of the processes of inflamaging, synthesis and degradation of the extracellular matrix, especially pronounced in old age.

scholarly journals No-Synthase Activity in Patients with Coronary Heart Disease Associated with Hypertension of Different Age Groups/ Aktivnost no-sintaze kod pacijenata s koronarnom bolešću srca povezanom s hipertenzijom kod različitih starosnih grupa

2016 ◽  
Vol 35 (1) ◽  
pp. 43-49 ◽  
Author(s):  
Anna Besedina
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Elderly Patients ◽  
Age Groups ◽  
No Synthase ◽  
Control Group ◽  
Aged Patients ◽  
Inos Activity ◽  
Major Mechanism ◽  
Enos Activity

SummaryBackground: Coronary heart disease is the leading cause of death and disability worldwide. Hypertension is a major independent risk factor for the development of CHD. Abnormalities in NO generation or activity have been proposed as a major mechanism of CHD. The purpose of this article is to determine the activity of eNOS and iNOS in patients with isolated CHD and CHD associated with HT of different age groups.Methods: Fifty patients with isolated CHD and 42 patients with CHD associated with HT were enrolled in this study. NOS activity was determined by nitrite anion formed in the reaction.Results: A statistically significant increase in iNOS activity is observed in elderly donors. In patients with isolated coronary heart disease cNOS activity is statistically significantly reduced with respect to the control group. The reduction of enzymatic activity of cNOS is more expressed in elderly patients than in middle-aged patients with coronary heart disease. Alterations in eNOS activity are more expressed in patients with coronary heart disease associated with hypertension than in patients with isolated coronary heart disease. Against the background of cNOS inhibition in the patients, a sharp increase in iNOS activity is observed.Conclusions: It has been shown that disturbance of endo - thelial function in patients with coronary heart disease associated with hypertension is characterized by reduced endothelial NO synthesis by cNOS and increased systemic NO synthesis due to increased iNOS activity. It has been found that the lack of endothelial NO and hyperproduction of »harmful« NO by iNOS are more expressed in elderly patients.

Effects of Qigong on Blood Pressure, Blood Pressure Determinants and Ventilatory Function in Middle-Aged Patients with Essential Hypertension

2003 ◽  
Vol 31 (03) ◽  
pp. 489-497 ◽  
Author(s):  
Myung Suk Lee ◽  
Myeong Soo Lee ◽  
Euy-Soon Choi ◽  
Hun-Taeg Chung
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Control Group ◽  
Middle Aged ◽  
Aged Patients ◽  
Urinary Catecholamines ◽  
Baseline Values ◽  
Sympathetic Nervous

This study was designed to measure changes in blood pressure (BP), urinary catecholamines and ventilatory functions of patients with mild essential hypertension after 10 weeks of Qigong (Shuxinpingxuegong). Fifty-eight patients volunteered to participate in this study and were randomly divided into either a Qigong group (n = 29), or a control group (n = 29). Systolic blood pressure and diastolic blood pressure decreased significantly in the Qigong group such that both became significantly lower after 10 weeks in the Qigong than in the control group. Also, there was a significant reduction of norepinephrine, metanephrine and epinephrine compared to baseline values in the Qigong group. The ventilatory functions, forced vital capacity and forced expiratory volume per sec, were increased in the Qigong group but not the control. These results suggest that Qigong may stabilize the sympathetic nervous system is effective in modulating levels of urinary catecholamines and BP positively, and in improving ventilatory functions in mildly hypertensive middle-aged patients.

scholarly journals Ten more years of life: Development and evaluation of a therapeutic education project for hypertensive patients. Preliminary results

2013 ◽  
pp. 239-246
Author(s):  
Maria D’Avino ◽  
Daniela Scala ◽  
Santolo Cozzolino ◽  
Barbara Andria ◽  
Crescenzo Simone ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Drug Therapy ◽  
Intervention Group ◽  
Therapeutic Education ◽  
Control Group ◽  
Hypertensive Patients ◽  
Education Project ◽  
Group I ◽  
Sf 36 ◽  
Per Capita

Introduction: The Ten More Years of Life Project is a therapeutic education project developed by the HypertensionWorking Group of the Cardarelli Hospital in Naples, Italy. It was designed reduce blood pressure (BP) in hypertensive patients by improving their compliance with physicians’ recommendations. Thanks to regional funding, the project was transferred from the hospital to the general practice setting. This article reports the preliminary results. Materials and methods: Eleven general practitioners (GP) participated in the project, and 821 hypertensive patients were enrolled. Patients were randomly assigned to the control group (Group C, n = 420) or the intervention group (Group I, n = 401). At baseline (t = 0) and 12 months later (t = 12), patients in both groups 1) filled out a 10-item multiple-choice questionnaire developed to evaluate the effect of the intervention on lifestyle modification, 2) responded to the Short Form Health Survey (SF-36) questionnaire, 3) had BP measured, laboratory data collected, and registration of current drug therapy. The Intervention Group patients took part in 3 interactive educational sessions held 2, 4, and 9 months after enrolment. The information was transmitted to patients by means of a printed leaflet, moderated group discussions, and role-playing sessions. The Control Group returned to the center 2, 4, and 9 months after enrolment and received the same information in verbal form from staff. Data were subjected to an intenton to treat analysis. Intergroup differences were evaluated with paired and unpaired t-test. Results: At the 12-month visit, significant reductions in BP (mm Hg) were observed in both groups: (Group I, t = 0: systolic BP = 137.3 + 15.6, diastolic BP = 83.8 + 8.5; t = 12: systolic BP = 130.9 + 13.7, diastolic BP = 81.4 + 7.9; Group C t = 0: systolic BP = 138.1 + 12.4, diastolic BP = 84.7 + 6.8; t = 12 systolic BP = 134.0 + 10.8, diastolic BP = 82.5 + 6.5) (P < 0.001 in both cases). In group I, drug therapy decreased in 22.7% of the patients, increased in 11.7%, and was unchanged in 65.6%. Corresponding proportions in Group C were 12.1%, 32.6%, and 55.3%. The reduction in BP in group I was associated with better adherence to physicians’ recommendations; that observed in group C was associated with increased use of antihypertensive drugs. In group I, drug expenditures decreased by a mean of EUR 3.15 per capita per month (versus EUR 1.80 per capita per month in Group C). Significant improvements were noted in some aspects of the lifestyle in both groups, but the SF-36 revealed better results for Group I patients. Discussion and Conclusion: Therapeutic education is a powerful tool for improving blood pressure control. This experience highlights the importance of patient involvement in the management of hypertension.

The Effects of Home-Based Self-Care Education on Blood Pressure and Self-Care Behaviors among Middle-Aged Patients with Primary Hypertension in Iran: A Randomized Clinical Controlled Trial

2021 ◽  
pp. 108482232110127
Author(s):  
Sara Hazrati Gonbad ◽  
Masoumeh Zakerimoghadam ◽  
Shahzad Pashaeypoor ◽  
Shima Haghani
Keyword(s):  
Blood Pressure ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Care ◽  
Primary Hypertension ◽  
Control Group ◽  
Middle Aged ◽  
Aged Patients ◽  
Care Education ◽  
Home Based

Self-care education (SCE) through home visit is one of the methods with potential effects on self-care. This study aimed to evaluate the effects of home-based SCE on blood pressure and self-care behaviors among middle-aged patients with primary hypertension in Iran. This randomized controlled trial was conducted on 110 middle-aged patients with hypertension recruited from public healthcare centers in the south of Tehran, Iran in September 2019. After convenience sampling, Participants were simple randomly allocated to control and intervention groups. Intervention group received a 2-month home-based SCE while control group received routine care services. Before and 2 months after the intervention, self-care behaviors were assessed using the Hypertension Self-Care Activity Level Effects (H-SCALE). Data were analyzed using the SPSS software (v. 16.0) at a significance level of less than .05. After 2 months, the posttest mean scores of self-care behaviors in medication adherence (17.42 ± 1.03 vs 14.49 ± 1.01, p = .04), physical activity (8.16 ± 0.39 vs 6.47 ± 0.52, p = .01), low-salt diet (52.51 ± 3.8 vs 35.36 ± 3.47, p = .001), and blood pressure control (3.47 ± 0.22 vs 2.42 ± 1.89, p = .001), in the intervention group were significantly greater than the control group. However, there were no significant between-group differences respecting the posttest mean scores of the weight management ( p = .06) and smoking cessation ( p = .2). Also, the mean blood pressure between the 2 groups changed after the intervention, but this difference was not statistically significant. This study suggests the effectiveness of home-based SCE in significantly improving self-care behaviors among patients with hypertension. But more studies are needed to measure the effectiveness of intervention on blood pressure. IRCT code: IRCT20190623043985N1. Registered 06/30/2019, https://fa.irct.ir/trial/40351 .

scholarly journals Age-associated level of myocardial fibrosis markers and chemokines in patients with acute coronary syndrome

2021 ◽  
Vol 20 (5) ◽  
pp. 2985
Author(s):  
O. A. Osipova ◽  
A. I. Golovin ◽  
O. N. Belousova ◽  
O. A. Zemlyansky ◽  
T. P. Golivets ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Direct Relationship ◽  
Age Groups ◽  
Tissue Inhibitor Of Metalloproteinase ◽  
Control Group ◽  
Middle Aged ◽  
Aged Patients ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Age Related

Aim. To study age-related specifics of the concentration of fibrosis markers and monocyte chemotactic protein-1 (MCP-1) in patients with ST-segment elevation acute coronary syndrome (STE-ACS).Material and methods. A total of 140 STE-ACS patients were examined. Depending on the age, participants were divided into following groups: middle age — 42 patients, elderly — 50 patients, senile — 48 patients. The control group (CG) consisted of 20 people without cardiovascular disease. The level of matrix metallopeptidase 9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), MCP-1 was determined by enzyme immunoassay. Statistical processing was carried out using the MATLAB 2020software.Results. It was found that in STE-ACS patients, the MMP-9 level in middle-aged patients is 2,9 times higher than in the CG (p<0,001), elderly — 4,1 times (p<0,001), senile — 6 times (p<0,001). A strong direct relationship was found between age and MMP-9 level (r=0,86088, p<0,001). The TIMP-1 level was higher in all patients (p<0,05) compared with CG. A strong direct relationship was found between levels of MMP-9 and TIMP-1 (r=0,7801; p<0,01). The MMP-9/TIMP-1 ratio was higher in the group of middle-aged people by 85,7% (p<0,05), elderly — 1,2 times (p<0,001), senile — 2,3 times (p<0,001) compared to CG. MCP-1 was elevated in all age groups (p <0,001). A direct correlation was found between levels of MCP-1 and MMP-9 (r=0,726, p<0,001).Conclusion. In STE-ACS patients, an age-associated increase in concentrations of MMP-9 and MMP-9/TIMP-1 ratio was found in comparison with CG, which indicates the predominance of intercellular matrix degradation marker in patients with ACS. At the same time, MMP-9 increase is possibly induced by MCP-1.

scholarly journals Impact of Pharmacist Counselling on Medication Adherence among Elderly Patients on Antihypertensive Therapy in a Tertiary Care Hospital of Nepal

2019 ◽  
Vol 1 (1) ◽  
pp. 40-47
Author(s):  
Sumitra Shrestha ◽  
Renu Karki ◽  
Mamita Ghimire
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Elderly Patients ◽  
Intervention Group ◽  
The Elderly ◽  
Control Group ◽  
Care Hospital ◽  
Hypertensive Patients ◽  
Elderly Hypertensive ◽  
Elderly Hypertensive Patients

Background: Poor adherence (compliance) is common with antihypertensive medications among elderly patients. As the elderly people are prone to multiple comorbidities, they are at higher risk of polypharmacy and therefore may present with a higher risk of non-adherence to medications compared to the younger population. The study was conducted to investigate the impact of pharmacist counseling on medication adherence among elderly hypertensive patients. Methods: The elderly hypertensive patients who visited the out-patient department at Chitwan Medical College (CMC) between August to November 2018. The face-to-face interview was conducted among 332 elderly hypertensive patients, selected with the purposive sampling technique. A paired t-test was used to show the difference between pre-test and post-test medication adherence. Results: It was found that 13.85% of patients were poor adherent and 86.14% low adherent in the intervention and the control group. The major reason for non-adherence was found to be carelessness about taking medicine (97%). The adherence score for intervention group changed from 1.60±0.83 to 3.95±0.56 (p-value < 0.001) while in the control group the average score before and after follow up was 1.48±0.77 and 1.51±0.80 (p=0.373) respectively. Blood pressure status improved in the intervention group than the control group (p<0.001). Polypharmacy was 27.71%, 15.66% of whom experienced adverse drug reactions. Conclusion: The patient medication counseling had a good impact on hypertensive patients. All factors of the Morisky Green Levine adherence scale improved after counseling and motivation. Pharmacist-led counseling improved medication adherence among elderly hypertensive patients. Keywords: Blood Pressure, Counseling, Elderly, Hypertension, Medication Adherence, Pharmacist

scholarly journals Relationship of anxiety-depressive disorders and cognitive dysfunction in patients with arterial hypertension depending on the age and status of physical activity

2020 ◽  
Vol 29 (3) ◽  
pp. 46-53
Author(s):  
T.V. Kolesnyk ◽  
A.V. Nadiuk ◽  
H.A. Kosova
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Elderly Patients ◽  
Arterial Hypertension ◽  
Cognitive Functions ◽  
Physical Inactivity ◽  
Anxiety And Depression ◽  
Middle Aged ◽  
Aged Patients ◽  
Level Of Education

Objective – to determine the level of anxiety and depression, to investigate cognitive functions and the status of physical activity in patients with hypertension, depending on age.Materials and methods. We examined 67 patients with hypertension I–III stage (atherosclerotic plaque and/or myocardial infarction in history). According to age classification (WHO, 2012) patients were randomized into 3 groups: group I – 25 middle-aged patients, group II – 22 elderly patients, group III – 20 patients of senile age. The highest level of education, the total number of education years; duration of arterial hypertension; anthropometric data and the office blood pressure were assessed. We used an individual approach to determine the target level of blood pressure according to the recommendations ESC/ESH 2018. Cognitive functions were evaluated using the MoCA-test and the Clock Drawing Test. The level of anxiety and depression was determined by the results of the Hospital scale of anxiety and depression.Results. According to the data obtained, a statistically greater degree of depression was recorded among eldery patients in comparison with other groups. Only in this group, a higher level of depression was associated with less time that patients spent for regular exercise during the week. Among middle-aged patients with arterial hypertension, the absence of anxiety and depression was detected in 56.0 %. At the same time, in the group of senile age, 75.0 % of patients were diagnosed with manifestations of anxiety and depression of varying severity. It is important to notice that in the group of senile age the median level of anxiety was higher, although nonsignificantly, in comparison with other groups and met the criteria for subclinical anxiety. Results of multivariate correlation analysis showed that a high level of anxiety in middle-aged patients was associated with an earlier age of arterial hypertension verification, as well as with waist circumference increase and the waist/hip circumference ratio. Among elderly patients, a higher level of anxiety was determined in the presence of physical inactivity and among patients of senile age, an increase in anxiety level was associated with a shorter duration of education and a decrease in cognitive functions. Conclusions. The highest level of depression was diagnosed among people of senile age, which was associated with the presence of physical inactivity. The groups did not differ statistically in level of anxiety, however, an increase in its severity in the middle-aged group was associated with an earlier age of hypertension verification and an increase in the degree of abdominal obesity, among elderly patients – with hypodynamia, and in the group of senile age – with a low level of education and the presence of cognitive dysfunctions.

NFLUENCE OF DRUG THERAPY ON DYNAMICS STRUCTURAL AND FUNCTIONAL INDICATORS OF THE HEART IN PATIENTS WITH HEART FAILURE OF ISCHEMIC ORIGIN IN DIFFERENT AGE GROUPS

2020 ◽  
pp. 8-18
Author(s):  
Елена Владимировна Гостева ◽  
Ольга Александровна Осипова ◽  
Людмила Валентиновна Васильева ◽  
Сергей Васильевич Жемчужников ◽  
Наталия Анатольевна Коренькова
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Randomized Study ◽  
Age Groups ◽  
Right Ventricular Dysfunction ◽  
Left Ventricular ◽  
Control Group ◽  
Middle Aged ◽  
Aged Patients

Цель исследования заключалась в выявлении особенностей структурно-функционального ремоделирования миокарда у больных хронической сердечной недостаточностью пограничной (40-49%) фракцией выброса (ХСНпрФВ) в разных возрастных группах и их коррекции на основе фармакотерапии. Проведено открытое рандомизированное исследование с участием 168 больных ХСНпрФВ ишемического генеза, средний возраст - 62,5±10,7 лет. В зависимости от возраста они были разделены: 1 группа - возраст от 50 до 59 лет, средний - 54,2 ± 4,1 года; 2 группа - от 60 до 74 лет, средний - 66,4 ± 6,2 года. Средние дозы небиволола через 12 месяцев составили 8,55±1,75 мг, бисопролола - 8,45±1,65 мг, эплеренона - 48,25±2,25 мг. Больные ХСНпрФВ ишемического генеза вне зависимости от возраста, имеют достоверно большие размеры левого желудочка, левого предсердия по сравнению с контрольной группой. С возрастом нарастает степень гипертрофии левого желудочка, увеличивается относительная толщина стенок левого желудочка, индекс объем/масса левого желудочка, что свидетельствует о концентрическом ремоделировании левого желудочка в среднем и пожилом возрасте. Наиболее выраженную дисфункцию правого желудочка имели больные пожилого возраста. Нами установлено, что через 12 месяцев при добавлении к терапии эплеренона у больных отмечалось более выраженное достоверное снижение размеров левого желудочка, индекса сферичности и индекса объем/масса ЛЖ. Улучшение диастолической функции правого желудочка отмечено только на фоне комбинированной терапии небивололом с эплереноном в группе больных среднего возраста. В группах больных (как среднего, так и пожилого возраста), принимавших комбинацию небиволола и эплеренона, отмечен переход всех больных в класс ХСН с сохраненной фракцией выброса The aim of the study was to identify the features of structural and functional remodeling of the myocardium in patients with chronic heart failure with a middle range (40-49%) ejection fraction (HFmrEF) in different age groups and their correction based on pharmacotherapy. An open randomized study was conducted with the participation of 168 patients with HF, with an average age of 62.5±10.7 years. Depending on their age, they were divided: 1 group-age from 50 to 59 years, the average-54.2 ± 4.1 years; 2 group - from 60 to 74 years, the average-66.4 ± 6.2 years. Average doses of nebivolol after 12 months were 8.55±1.75 mg, bisoprolol-8.45±1.65 mg, eplerenone-48.25±2.25 mg. Patients with HFmrEF, regardless of age, have significantly larger sizes of the left ventricle and left atrium compared to the control group. With increasing age the degree of left ventricular hypertrophy, increased relative wall thickness of left ventricle, index volume/mass of the left ventricle, evidence of concentric remodelling of the left ventricle in middle and old age. Elderly patients had the most pronounced right ventricular dysfunction. We found that after 12 months, when eplerenone was added to therapy, patients had a more pronounced significant decrease in the size of the left ventricle, the sphericity index, and the LV volume/mass index. Improvement of diastolic function of the right ventricle was observed only in combination therapy with nebivolol and eplerenone in a group of HFmrEF middle-aged patients. In groups of patients (both middle-aged and elderly) who took a combination of nebivolol and eplerenone, the transition of all patients to the class of HF with a preserved ejection fraction was noted

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